Chris Helms: Nurses want collaboration not confrontation

THERE has been significant media coverage regarding the legislative changes on MBS/PBS subsidies for nurse practitioners (NPs).

Reports abound of physician groups refusing to accept patient referrals from NPs, fears of a sharp rise in acute renal failure due to nurses inadvertently exposing their patients to the “triple whammy” of ACE-inhibitors, diuretics and NSAIDs, and the general collapse of the health care system due to the sudden influx of prescriptions that will be written by NPs for their clients.

At the risk of sounding cavalier, it feels a bit like Chicken Little, really.

These claims are made despite the overwhelming evidence demonstrating a 10-year history of safe, efficacious, and cost-effective care provided by NPs here in Australia and worldwide since the 1960s.

I find all this unusual because I trained as an NP alongside medical colleagues in the United States.

There was true collegiality and respect for the perspectives that the nursing and medical models afforded.

We worked in collaboration, offering complementary health care that brought about the best possible outcomes for our clients.

I acknowledge that the US health care system is far from perfect, but at the end of the day patient care still remains much the same as in Australia.

I believe that the medical model does not offer the complete answer to an effective health care system — and neither does the nursing model.

Neither model operates to its full capacity without collaboration with and facilitation by the other.

So why are we, as collaborating health care professionals, engaging in shock and fear media reports, which do nothing but instil public distrust in the health care system?

Instead of engaging in these arguments that accomplish nothing apart from wasting time and money, why don’t we truly collaborate and encourage each other’s professional aspirations, talents and abilities?

Is there a perception that nurses can’t possibly have the training, experience or intelligence to safely manage a patient with heart failure or other complex illness?

NPs in Australia have advanced training at the Masters level with an emphasis on pharmacotherapeutics, diagnostics, differential diagnosis and advanced physiology.

Many of us have trained alongside or taken the same courses as our medical colleagues.

We have been accredited by a national body using standards that are rigorous and discerning.

We have years of practical experience working with clients within our respective specialties and have done so efficiently, safely and effectively without the pharmacological or diagnostic tools that have traditionally been used by the medical profession.

Allowing NPs to access the MBS and PBS aids in the progression and evolution of the nursing profession, validates the delivery of quality NP patient care, provides for improved health care access and accommodates patient choice.

This natural professional evolution cannot occur without the support of our medical colleagues.

Likewise, the medical profession could not have evolved without the support of their nursing colleagues through their training and care delivery to patients, families and communities.

This is our opportunity to strengthen our partnerships using innovative health care delivery teams in an attempt to provide one of the solutions for this country’s ailing health care system.

My physician mentor once said to me: “Chris, you must have the courage of your convictions.”

I invite you to have the courage to join the many nurses and physicians who have decided to stand in support of the NP profession and explore how this role may benefit your practice and clientele.

Mr Chris Helms is vice-president of the Australian College of Nurse Practitioners.

Posted 22 November 2010